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General NPI Number Information
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NPI Number | 1457614240
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Entity Type | Organization
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Legal Business Name | UNITED FAMILY MEDICAL CENTER
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 10941 FIRESTONE BLVD
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City | NORWALK
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State | CA
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Zip | 90650-2242
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Country | US
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Telephone | 562-864-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 10941 FIRESTONE BLVD
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City | NORWALK
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State | CA
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Zip | 90650-2242
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Country | US
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Telephone | 562-864-4200
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | IAONNIS G GIANNIKOPOULOS
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Credential | MD
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Telephone | 562-864-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | C41277
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License Number State | CA
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